Eye injuries and ocular complications present to many health care professionals through emergency department visits, convenient care appointments or primary care evaluations; however, accurate ocular examination typically requires specialty training and expert knowledge of the use of ophthalmic diagnostic equipment such as the slit lamp biomicroscope. The limited instruction available on these devices and restricted access to the equipment due to the high cost and immobility, inhibit the ability for primary care providers to adequately diagnose, triage, or manage complicated ocular conditions. This is particularly problematic when cases of serious ocular injuries, that require urgent attention, present outside of an ophthalmology office. This occurs in patients with a suspected ruptured globe or post-operative infections.
Current methods for evaluating the integrity of the anterior globe in trauma patients and the wound integrity in post-operative patients involve the use of the Seidel Test. This test is performed by placing a high concentration of fluorescein dye into the ocular tear film and then observing for a change in the color of the dye. The change in color would indicate the passage of aqueous humor through a corneal or anterior scleral wound, which represents a direct communication of the internal eye fluid with the external tear film. The Seidel Test is subjective and not standardized, and the amount of pressure and technique used when performing this test varies between clinicians. Other devices that are used to aid in diagnosis of trauma patients include conventional X-ray, computed tomography (CT), ultrasound (US), and magnetic resonance imaging (MRI), but they are limited in their capability to detect eye injuries. Specifically, plain film radiographs have no utility in detecting soft tissue injuries to the eye; CT images do not visualize small anterior lacerations to the cornea, and US is contraindicated with anterior globe ruptures. In addition, all of these imaging devices are expensive and are restricted to hospital settings due to their size and cost. Furthermore, none of these devices are available for evaluation of an eye trauma by first responders in the field or for military use in combat settings.
Compositions and methods are needed in the art for inexpensive, point of care diagnosis of eye injury and disease.